Insulin Pump VS MDI – Multiple Daily Injections

When choosing which method of taking care of your diabetes presents itself, it’s nice to have an unbiased compare/contrast list to figure out which might be best for you. So if you are thinking of switching up how you deliver insulin, keep reading.

Insulin Pump

Positives:

continuous insulin delivery
one type of insulin used
increased ability to fine tune basal rates
microbolus possible (.025u, depends on pump brand)
one injection every three days (depends on what type of cannula used)
stores all data, example: insulin dose, dose time, active insulin, blood sugar, etc (depends on independent pump brand)
pump and CGM combined in one device (depending on brands used)

Possible negatives:

COST. Including the pump and continuous consumables needed
higher risk of undelivered insulin
subjective, but disease is visible
bulky and always attached
must be worn nearly 24/7 (excluding showering, sex, etc)
risk of diabetic lipohypertrophy (fat accumulation from multiple injections in same area which effects insulin absorption)
skin sensitivity to adhesives
if CGM is used, two areas with devices attached to body
environmentally wasteful: batteries, plastic packaging, etc

Multiple Daily Injections (MDI) includes pens or syringes

Positives of pens:

portable, pre-filled pens to deliver insulin as needed by injection, insulin is dialed out and pushed in
disease is not obviously visible
more options of injection sites
socially flexible treatment option
needle sizes can be customized

Possible negatives of pens:

insulin leakage if not held after injection for longer than 30 seconds (adequate time to prevent leakage is not exact)
need to inject basal insulin at same time(s) per day
two types of insulin needed, basal (slow release) bolus (mealtime – fast acting)
no way to record dosing after injected (must be pen & paper, or an app like MySugr)
insulin waste from priming needle
typically only able to inject in full 1u increments

Positives of syringes:

more options of injection sites
insulin can be injected in .5u increments
disease is not obviously visible
no insulin leakage after injection

Possible negatives of syringes:

must fill insulin into syringe
need to inject basal insulin at same time(s) per day
two types of insulin needed, basal (slow release) bolus (mealtime – fast acting)
no way to record dosing after injected (must be pen & paper, or an app like MySugr)

This list is not conclusive, and technology is advancing quickly. In the end, each individual will need to weigh the pros/cons to their own personal preferences to make a decision on which method is best. There is not a one-size-fits-all method.

Although not readily available everywhere, “smart” insulin pens could provide a great alternative to an insulin pump for those who do not want to be tethered. These smart insulin pens have a lot of functionality like tracking insulin dosing, insulin delivery to the .1u (beginning at .5u), Bluetooth or USB function to read data on a computer, etc.

And please don’t be fooled into believing that an insulin pump provides better control. Precise control is possible with all delivery methods. Period.

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